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Middle Ear Infection / Acute Otitis Media


The medical name for a middle ear infection is Acute Otitis Media. This is a very common infection in children, usually in those aged under two years. Most children will get at least one infection.

What happens when the child has a middle ear infection?


Children with infection will have a cold, pain and fever, and will often be crying and unwell. The ear drum may then perforate: this usually means that the infection can then discharge outwards, which you will see as a runny ear. When the ear drum bursts, the pain often gets better, because the infection is then allowed to drain outwards.

Are antibiotics needed?


In the past, antibiotics were often given for acute otitis media, but we now know that most infections settle without the need for antibiotics. Don't be surprised if your doctor recommends painkillers such as paracetamol rather than antibiotics. If infection isn't settling, or is particularly severe, then antibiotics may be given. If the ear is leaking, antibiotic ear drops are usually very effective.

Can I do anything to stop infections?


To reduce the infections, make sure that no one that is in contact with the child smokes. Remember, even if you smoke away from the child, the smoke still sticks to clothes and hair, and your child still gets exposed to it. Stopping dummy use also helps reduce ear infections. A dummy changes how the Eustachian tube works, which means the bacteria from the back of the nose are more likely to get to the ears (the Eustachian tube is a tube that connects the back of the nose to the middle ear).

What about grommets?


If your child has 3 or more infections in 6 months, or 4 or more in a year, this is called Recurrent Acute Otitis Media. Parents ften wonder whether grommets would help. Grommets do make infections less frequent and less severe, but they don't make then disappear completely. Even with grommets, ear infections still happen. Grommet insertion is also a surgical operation, and therefore comes with some risks (see grommets page). An alternative to grommets are long-term antibiotics, but again that is something that we mostly try and avoid because of risks associated with antibiotic use (development of resistant bacteria, side effects such as diarrhoea). Because Acute Otitis Media in children usually resolves with time, it is often best to do nothing and just wait for the child to get older. However, if your child is severely affected, or has associated hearing problems (see glue ear), then grommet insertion can be helpful.

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